While writing does not always come easy, one of the
things I like most about writing the Talk Clean To Me Blog is that I can state
my opinion in black and white with the hopes that some may agree and welcome
the dialogue that occurs with those of you who think I’m completely off my
rocker.
In the world of cleaning and disinfection, the science or
proof some people rely on cannot keep up with the myriad of new products or
processes that enter the market place.
Does this mean that one should not consider changing products or
processes until such time as there is statistically significant information
published about these new products or processes? Most definitely not!
proof some people rely on cannot keep up with the myriad of new products or
processes that enter the market place.
Does this mean that one should not consider changing products or
processes until such time as there is statistically significant information
published about these new products or processes? Most definitely not!
Let’s consider the pre-moistened disinfectant wipe. Are they new to the market? NO. Have
they been used successfully at many facilities across the globe? YES.
To ensure a successful infection prevention program, do we need to
consider how to use them correctly to ensure the desired outcome? MOST DEFINITELY!
they been used successfully at many facilities across the globe? YES.
To ensure a successful infection prevention program, do we need to
consider how to use them correctly to ensure the desired outcome? MOST DEFINITELY!
In a recent infection prevention and control guideline for environmental cleaning and disinfection the following statement was
included:
included:
“Disinfectant wipes should be used by the primary care
giver for point of care cleaning and disinfecting of patient equipment. They
should not be used as a routine cleaning disinfectant tool.”
giver for point of care cleaning and disinfecting of patient equipment. They
should not be used as a routine cleaning disinfectant tool.”
Admittedly, for the sake of keeping the blog to a
reasonable length, I have not included the entire section, however, should you
take the time to read the guideline, you will find that it is vague and without
any references to support its justification.
While I agree wholeheartedly that all disinfectants must be used
appropriately, the danger in making such a statement is that there is no strong
scientific evidence to conclusively limit the use of pre-moistened wipes at
this time. Perhaps instead, there
should have been a more detailed discussion about the appropriate use of
pre-moistened disinfecting wipes to ensure that they are used in such a fashion
as to ensure contact time in accordance to the label is met. Many of the leading pre-moistened wipes
available on the market are Quat-alcohol based products with anywhere from 2 to
5 minute contact times. As proven by
science, such products will not remain on the surface for the contact time
listed on the label as a result of the rapid evaporation rate of alcohol. In fact a study published by Omidbakhsh in 2010 in the Journal of AOAC International investigated the discrepancy between
drying time and contact time with respect to product efficacy. Additionally, there have been publications
investigating the effects of wipes in contaminating surfaces providing
compelling evidence that we want to use 1 wipe for each surface especially if
using a weak or slow-acting disinfectant in the wipe where the true chances of
achieving disinfection are limited at best.
reasonable length, I have not included the entire section, however, should you
take the time to read the guideline, you will find that it is vague and without
any references to support its justification.
While I agree wholeheartedly that all disinfectants must be used
appropriately, the danger in making such a statement is that there is no strong
scientific evidence to conclusively limit the use of pre-moistened wipes at
this time. Perhaps instead, there
should have been a more detailed discussion about the appropriate use of
pre-moistened disinfecting wipes to ensure that they are used in such a fashion
as to ensure contact time in accordance to the label is met. Many of the leading pre-moistened wipes
available on the market are Quat-alcohol based products with anywhere from 2 to
5 minute contact times. As proven by
science, such products will not remain on the surface for the contact time
listed on the label as a result of the rapid evaporation rate of alcohol. In fact a study published by Omidbakhsh in 2010 in the Journal of AOAC International investigated the discrepancy between
drying time and contact time with respect to product efficacy. Additionally, there have been publications
investigating the effects of wipes in contaminating surfaces providing
compelling evidence that we want to use 1 wipe for each surface especially if
using a weak or slow-acting disinfectant in the wipe where the true chances of
achieving disinfection are limited at best.
That said, proper disinfection with such wipes can be
achieved with the physical action of wiping provided the disinfectant itself
has a good and rapid broad-spectrum microbicidal activity. Therefore, there has
to be a change in our thinking with regards to contact time for wipes as
opposed to longer contact times needed when just spraying or pouring a liquid
on surfaces. Perhaps the conclusion should be that in choosing a pre-moistened
disinfectant wipe, one must consider more than just the cost per wipe. There
needs to be a more fulsome investigation as to the number of wipes needed to
achieve the contact time as listed on the label. We need to review how the wipes will be
utilized to ensure that good physical friction will be applied to help in
removal of the pathogens from the surface, as well as frequent changing of such
wipes to avoid redistributing the removed pathogens. Lastly, one cannot discount the size of the
wipe. Certainly, the traditional wipes
used in clinical areas for disinfecting patient care items such as BP Cuffs or
Stethoscopes would not be recommended for use by Environmental Services due to
their smaller size, however, most companies specializing in pre-moistened wipes
provide larger options (10x10 inches or 12x12 inches) which are more than
adequate for cleaning larger surfaces sizes.
achieved with the physical action of wiping provided the disinfectant itself
has a good and rapid broad-spectrum microbicidal activity. Therefore, there has
to be a change in our thinking with regards to contact time for wipes as
opposed to longer contact times needed when just spraying or pouring a liquid
on surfaces. Perhaps the conclusion should be that in choosing a pre-moistened
disinfectant wipe, one must consider more than just the cost per wipe. There
needs to be a more fulsome investigation as to the number of wipes needed to
achieve the contact time as listed on the label. We need to review how the wipes will be
utilized to ensure that good physical friction will be applied to help in
removal of the pathogens from the surface, as well as frequent changing of such
wipes to avoid redistributing the removed pathogens. Lastly, one cannot discount the size of the
wipe. Certainly, the traditional wipes
used in clinical areas for disinfecting patient care items such as BP Cuffs or
Stethoscopes would not be recommended for use by Environmental Services due to
their smaller size, however, most companies specializing in pre-moistened wipes
provide larger options (10x10 inches or 12x12 inches) which are more than
adequate for cleaning larger surfaces sizes.
Perhaps the use of pre-moistened disinfectant wipes is no
different than the use of antibiotics?
When prescribing antibiotics you need the right drug at the right
concentration for the right length of time.
For pre-moistened wipes you need the right claims, the right contact
time and the right size to do the job.
different than the use of antibiotics?
When prescribing antibiotics you need the right drug at the right
concentration for the right length of time.
For pre-moistened wipes you need the right claims, the right contact
time and the right size to do the job.
So….am I off my rocker?
Bugging Off!
Nicole
